| NPI | 1972862902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HARRISON CAO 313-745-6911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TE1100X Psychologist, Exercise & Sports | |
| 103TF0000X Psychologist, Family | |
| 103TH0004X Psychologist, Health | |
| 103TH0100X Psychologist, Health Service | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TR0400X Psychologist, Rehabilitation | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2023-09-29 |